The Gundersen Lutheran Center for Cancer and Blood Disorders, located in La Crosse, Wisconsin, provides cancer care for a predominantly rural population of 560,000 comprising 19 counties in western Wisconsin, northeastern lowa, and southeastern Minnesota. A substantial proportion of the population served in this Tri- state area is considered a Medically Underserved Population or lives in a Health Professional Shortage Area, as designated by the Department of Health and Human Services (DHHS). Of the counties outside of La Crosse, 70%, 60%, 20%, and 5% are considered underserved by DHHS due to geographical area, low income, presence of a correctional facility, or having a Native American tribal population, respectively. Approximately 3% of the population is from ethnic minority groups including Hmong, Native American, and Hispanic. The core of the proposed Community Clinical Oncology Program (CCOP) will be composed of 5 medical oncologists, 4 hematologists, and 4 radiation oncologists, all of whom are employed by the same health system. The group has a strong history of clinical research, with over 30 years of clinical trial experience enrolling over 1200 patients into National Cancer Institute (NCI) (ECOG, RTOG, COG, GOG, ACOSOG, and CTSU) and industry-sponsored trials. In alignment with and complementary to its NCI National Community Cancer Centers Program, the proposed CCOP will enhance clinical trial accrual among the population it serves with the following action plans: 1) offer clinical trial access to a wider geographic area by implementing research infrastructures in rural outreach sites;2) increase accrual to cancer control/prevention and treatment trials by forming affiliations with new CCOP research bases;3) improve research participation of minority groups by providing education and cancer screening opportunities;and 4) enhance clinical trial participation (especially to cancer control/prevention trials) among care providers from other medical specialties by regularly promoting clinical trial awareness during various multidisciplinary cancer conferences. We expect to exceed the minimum number of required accrual and meet standard requirements for quality assurance and human subject safety. RELEVANCE: Our proposed CCOP will provide and enhance clinical trial access to a rural population in the Midwest, predominantly underserved due to geographical barriers. Several pockets of minority groups (Native American, Hmong, and Hispanic) across a wide area will also be targeted.